Email *

Child Date of birth *

If they were premature, please identify their adjusted age. This assessment goes off of adjusted ages.

1. How would you describe your baby’s muscle tone when you hold or touch them?

Floppy or soft

Tight or stiff

in between

2. My toddler can move into and out of standing using furniture for support.

True

False

3. My toddler is cruising (walking) along furniture, including around corners.

True

False

4. My toddler can let go and stand without support for a few seconds.

True

False

5. My toddler can take several steps on their own without support.

True

False

6. How would you describe your toddler’s walking pattern?

Launch mode: I need to keep my hands ready and surround them with soft furniture.

Toe walking: They walk on their tiptoes most of the time.

Controlled: They can stop on their own or with just a little help.

7. My toddler can squat down to pick something up when holding onto something for support.

True

False

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